Objective: To evaluate the effect on clinical practice of training primary care providers (PCPs) in an approach to brief behaviour change counselling (BBCC), integrating the 5As (ask, alert, assess, assist, arrange) with a guiding style derived from motivational interviewing in the South African context. BBCC was focused on the four risky behaviours (unhealthy eating, tobacco smoking, physical inactivity, harmful alcohol use) for non-communicable diseases.
Methods: It was a before-and-after design, recording BBCC skills at baseline, directly after training and 6-weeks later. We evaluated each recording for adherence to the guiding style and delivery of the 5As using the Motivational Interviewing Treatment Integrity 3.1.1. tool, and a tool based on the 5As training design.
Results: 123 recordings were collected from 41 PCPs. Results showed a significant improvement in adoption of the guiding style (e.g. global score at baseline 2.0 (2.0-2.6) and in clinical practice 3.0 (2.7-3.3) p<0.001) and completion of the 5A steps (e.g. assist score at baseline 1.26 (1.12-1.4) and in clinical practice 1.75 (1.61-1.89) p<0.001).
Conclusion: Training PCPs in this approach to BBCC is effective at changing their clinical practice in the short term.
Practice implications: The training programme should be integrated into the curricula of PCPs, and used in continuing professional development.
Keywords: Brief behaviour change counselling; Clinical nurse practitioners; Motivational interviewing; Primary care physicians; Training programmes.
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